African people infected with HIV-1 who also have NRTI/NNRTI use and metabolic syndrome have an increased risk of cardiovascular disease. Titus Francis Msoka described this in his Amsterdam dissertation.
The results of Msoka and colleagues indicate that the main culprit for the increased cardiovascular risk is the virus itself. The use of NRTIs or NNRTIs and the metabolic syndrome play an amplifying role.
The Amsterdammers also found that so-called elite controllers, HIV-infected people whose HIV replication is controlled to undetectable levels without ART, had more coronary atherosclerosis and monocyte activation than uninfected people. This indicates that the main cause of this comorbidity is related to the HIV infection itself.
In their study of elite controllers, Msoka and colleagues also showed that those who maintained viral control had a different immune metabolism than those who had transient viral control. This indicates that targeting immune metabolism could reduce the risk of atherosclerotic cardiovascular disease in HIV-1 infected populations, namely by enhancing the immune response and thereby removing HIV-1 from reservoirs.
Bron:
Msoka TF. Risk factors for cardiovascular disease in HIV 1-infected patients in sub-Saharan Africa: risk factors for CVD in HIV 1-infected patients in SSA. Dissertation, VU University Amsterdam, 31 May 2022.
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